Birth Control

Contraception has been used worldwide since ancient times. Writings in Egyptian papyri, the Bible, and Greek and Roman texts indicate the usage of various herb and root preparations for contraception and abortion (Riddle 1992). Decisions regarding the timing of pregnancy and control over family size continue to be important issues for all adults.

An average woman in the developing world who wants four children must use effective contraception for sixteen years. The average U.S. woman who wants two children needs to effectively use contraception for twenty years to achieve her desired family size (Alan Guttmacher Institute 1999).

Worldwide, many contraceptive methods are available. Factors influencing the choice of method include availability, cost, reversibility, ease of use, cultural preferences, privacy, side effects, and medical risks. When evaluating risk, it is important to note that all available birth control methods carry lower risk of death than pregnancy, even in developed countries where maternal death rates are already low.

Patterns of use differ significantly internationally. The oral contraceptive pill accounts for 34 percent of contraceptive use in the Netherlands, but only 2 percent in Japan. The intrauterine device provides contraception for 19 percent of French women, but only 1 percent of U.S. women (Senanayake and Potts 1995). Conversely, the United States has the highest rate of female sterilization in the developed world.

Contraceptive methods have many different mechanisms of action, but may be generally grouped into hormonal or nonhormonal classes.